OR nursing QUESTIONS

Ferret · Mar 21, 2004

Hmm, a lot of points there. We count accountable items with the scout as set out by ACORN, our version of AORN. These include sponges, gauzes, needles, blades, haemostats, towel clips, bulldog clips etc, anything that is small or likely to be left in the wound. We do two counts aside from the initial count, for example when closing peritoneum and when closing skin.

The anaesthetic team usually does the positioning and padding with the orderlies, although the scout is responsible to ensure patient safety and keeps an eye on them. The scout starts the paperwork and fills in most of it, although often the scrub writes in what the title of the case was. The scrub is responsible for the count, and signs the papers to that effect at the end of the case. They also are responsible for checking the consent and allergies before scrubbing.

Prepping and draping are part of the same process and are performed by the scrub while scrubbed. The scout does all the opening and fetching and paperwork, checks the diathermy and padding... and still is the junior nurse.

orrnlori, RN · Mar 21, 2004

Your work is much more evenly distributed where you are. I think I might like it. Although we discuss positioning with the surgeons and anesthesia, the circulator (with the help of the residents) do that, we don't have orderlies in the OR or any anesthesia staff except the CRNA or the attending. If it is a scrub tech, they aren't allowed to touch any of the offical paperwork, but another nurse who will scrub the case can help with the paperwork if there is time before she needs to scrub in and if the circulator is very busy.

Although I like some of the scrub techs I work with very much, I still wish they were not allowed in the OR. I see it as a way for the hospital to just save money and displace a nurse. All the nurses who scrub WANT to scrub because it's so much less heavy work and running for stuff. I know I'd rather scrub, it's like a breath of fresh air.

Thanks for taking time to answer my questions.

TMnurse · Mar 21, 2004

If you circulate... you will not be in one spot for long. So don't worry too much about that. Here's a funny thing. I have found about nursing. There is this certain population that seems to think you have to do Med-Surg nursing or your a failure and not really a nurse. I disagree. Here;s an idea. I would take this opportunity to get OR experience. As in some places, it is very hard to get into the OR so don't pass it up. After about a year, you will be fairly comfortable then try something new by splitting time. I have worked in the OR for 3 years and do everything (scrub/circulate) except cardiac . I will now be working in one of our surgical clinics and splitting time between the two jobs. When I decided to do this I asked around about where some opps might be to try something different. Holy smoke!!! I mean once you start looking there are tons of jobs... psy... ER... Clinics/office.. back to the floor (which I was down with)... home care (thought you'd have to have years of med surg but found some agency would train you---even an OR nurse). Here's the thing. If you can get in the OR now try it, it might not be so easy to go from Med/Surg to the OR years down the road. GOOD LUCK.

Hi, I am a nursing student and trying to figure out if the OR might be a good place for me to practice nursing. There have been several posts suggesting that OR nurses really enjoy their jobs (mostly) and some that wouldn't want to work in any other area. I wondered if someone might be able to tell me: what it is about this specialty that draws and retains the nursing staff? What is the BEST thing about OR nursing? Also, curiously, just standing in one position is hard on my feet and painful. I assume it probably is for most people, initially. Is this something you develop a tolerance for, do you have any suggestions that may help, any better types of shoes, or is this maybe just not a good area for me? Any input would be appreciated! Thanks for your time!

Ferret · Mar 22, 2004

G'day All,

No offence to any individual technicians reading this, but the spread of technicians is like cancer... once you let them get a foothold, you're stuffed. We have tecnicians taking over the anaesthetic nursing positions, and while they are great people, they threaten nursing jobs. The nursing wage is such a huge part of a hospital budget, that anything that can reduce it is a joy to the beancounters, to the detriment of those on the floor.

As Orrnlori said, things seem more balanced here, and the more I hear about American procedures, the happier I am to stay here, and forgo the "joys" of travel nursing. The trends your policies have followed have given us clear battlelines to stand at and refuse to give way, for we know the consequence of backing down. I don't know if there is any way for you to reverse the trend, short of a policy change to not hire any more technicians... perhaps you could slip that one under the pennypincher's radar. I wish you luck, for the sake of nursing worldwide. The nature of our jobs are changing fast, and it is up to us all to ensure that we still have a place in the future of healthcare. Good Luck!

orrnlori, RN · Mar 22, 2004

Our scrub techs don't last very long, we usually just get them trained and they are off to somewhere else. I don't know why we keep spending money to train them, seems it would make more sense, since the nurses stay, to just have nurses. Hope you are able to keep them at bay downunder. I don't see how we can stop the practice here. It was going on long before I came to the OR and I'm sure will continue after I'm gone. I think if more nurses were willing to learn to scrub it would help. But some of the nurses I work with are terrified of scrubbing. I was afraid at first but then I thought if someone with one year of tech school can do it, I certainly can do it.

Ferret · Mar 24, 2004

G'day All,

What's to be afraid of? With my scouting experience, I started on my first day off orientation for my new course with a D&C, and now, within a month, am scrubbing independantly for quite complex laparotomies, and STILL loving every minute. As with all training, scrub practice starts with someone double scrubbed on a simple case, and works on up. We need to take these people gently by the hand and show them that there is nothing to be afraid of.... before the triple A crashes through the door 8^)

orrnlori, RN · Mar 24, 2004

Well, some nurses just don't want to learn. You can't make someone do what they don't want to do. Believe me, I've given the speech to some that if you don't learn they'll just bring in another scrub tech. I was nervous when I was learning but it didn't stop me from doing cause I think it's so much fun. I'll still have the charge nurse ask me from time to time can I scrub this, can I scrub that when he's making assignments. Unless it's heart, lung or brain, I pretty much say, yeah, I can. That's pretty much how I've learned much of what I scrub, just saying I can and then figuring it out when I'm at the field. If you're a good circulator you've see it done before so you have some pretty good inclinations of what you're doing. Sometimes I just tell the docs I haven't done something in a long time (when maybe I really never did it at all) they are very cool with it.

nursemichelle · Mar 24, 2004

:imbar Sorry to ask...what does it mean when you say "scrub"--I mean I know the "normal" meaning, but what does it mean in medical terms? What exactly does a scrub tech do? Thanks...trying to figure all this out :imbar

orrnlori, RN · Mar 24, 2004

Don't be embarrassed, never know until you ask. There are usually two primary nurses in the OR, the circulator and the scrub. The circulator remains unsterile and runs the room, and has primary responsibility for the patient's needs and planning the case, the scrub nurse (or tech) scrubs in, gowns and assists the doctors, handing instruments, suture, laps, etc. They remain sterile and at the field at all times. They have to know how the surgery is suppose to unfold and have all the instruments available and at hand so when the doctor asks for the instrument they hand it right to them. It's fun to scrub.

mcmike55 · Mar 25, 2004

Hi, I am a nursing student and trying to figure out if the OR might be a good place for me to practice nursing. There have been several posts suggesting that OR nurses really enjoy their jobs (mostly) and some that wouldn't want to work in any other area. I wondered if someone might be able to tell me: what it is about this specialty that draws and retains the nursing staff? What is the BEST thing about OR nursing? Also, curiously, just standing in one position is hard on my feet and painful. I assume it probably is for most people, initially. Is this something you develop a tolerance for, do you have any suggestions that may help, any better types of shoes, or is this maybe just not a good area for me? Any input would be appreciated! Thanks for your time!

To BSN student. I am a veteran of over 20 years in a rural Ohio, small hospital OR. We run only 3 rooms, no heart, neuo, etc. I have been in the "hospital game" as a volunteer, orderly, student and now RN since the 60's. Other than emergency (and trauma/helicopter) there is no place I would rather be than in surgery. I like the one on one, hands on aspects. I also like working closely with the doctors. If I have a question about a med or something, they are usually right there to ask. I really like it when the doc really doesn't have to say anything to me, because I know what he wants and he trusts me to deliver!! There is the down side of course. Needle sticks, long hours, sleep depravation, and no thank you snacks :chuckle .

But I wouldn't trade it for a million dollars.......well maybe a million!! :rotfl:

Hope that helps. Mike

P.S. I think, at least in my little corner of the world, a good nursing education, and a bit of experience in other areas of the hospital help.

Mike